BACKGROUND: This study was performed to compare the effectiveness of cholesterol-lowering diet therapy instructed by physicians with that instructed by dieticians using techniques that remove regression to the mean. METHODS: 118 patients who visited the office of Family Medicine department in Pusan Paik Hospital from February to November, 1996 and had serum total cholesterol(TC) concentrations greater or equal to 200mg/dL from two measurements were enrolled. The patients were divided into two groups randomly according to the cholesterol-lowering dietary education methods : the one was educated by physicians(Group I), and the other by dieticians(Group II). We evaluated the differences of lipid levels after education in consideration of regression to the mean. RESULTS: The mean reduction in TC concentrations achieved by dietary therapy was 10.7 % and 7.3%(without and with adjustment for regression to the mean) in Group I, and 9.8 and 6.5%(without and with adjustment, for regression to the mean) in Group II. The baseline TC concentrations and TC concentrations after dietary therapy were significantly different in individual group regardless of adjustment for regression to the mean. However, the reduction degrees of TC concentrations were not significantly different between two groups. CONCLUSIONS: The results indicate that even after adjustment for regression to the mean, dietary therapy will achieve the expected reduction. And it seems that the diet education by physicians will be effective as much as that by dieticians.
Busan ; Diet Therapy ; Diet* ; Education ; Humans ; Nutritionists*

Polyvinyl chloride (PVC) is a widely used chemical for production of plastics. However occupational asthma (OA) caused by PVC has been reported only rarely. We report a 34-yr-old male wallpaper factory worker with OA due to PVC and nickel (Ni) whose job was mixing PVC with plasticizers. He visited the emergency room due to an asthma attack with moderate airflow obstruction and markedly increased sputum eosinophil numbers. A methacholine challenge test was positive (PC20 2.5 mg/mL). Bronchoprovocation tests with both PVC and Ni showed early and late asthmatic responses, respectively. Moreover, the fractional concentration of exhaled nitric oxide (FeNO) was increased after challenge with PVC. To our knowledge, this is the first case of OA in Korea induced by exposure to both PVC and Ni. We suggest that eosinophilic inflammation may be involved in the pathogenesis of PVC-induced OA and that FeNO monitoring can be used for its diagnosis.
Adult ; Asthma, Occupational/*chemically induced/*diagnosis ; Breath Tests ; Bronchial Provocation Tests ; Environmental Exposure ; Eosinophilia/*diagnosis ; Exhalation ; Humans ; Leukocyte Count ; Male ; Nickel ; Nitric Oxide/metabolism ; Occupational Exposure ; Plasticizers ; Polyvinyl Chloride

No abstract available.
Acquired Immunodeficiency Syndrome ; Cytomegalovirus ; Cytomegalovirus Infections ; Humans

PURPOSE: To determine the characteristic CT findings of infectious sacroiliitis and ankylosing spondylitis. MATERIAL AND METHOD: We retrospectively reviewd CT findings in 10 patients with infectious sacroiliitis confirmed by culture and clinical follow ups and in 5 patients with ankylosing spondylitis by HLA-B27 typing. Mean ages were 30 years in ankylosing spondylitis and 29 years in infectious sacroiliits. CT scans were obtained with GE 9800 or Toshiba 900-S scanner. We analyzed CT findings in regard to the morphology and the degree of bone erosion, and the adjacent soft tissue change. RESULT: All cases of ankylosing spondylitis had bilateral and asymmetic bone erosion, predominantly in ilium, showing subchondral sclerosis on ilium. Infectious sacroiliitis showed unilateral involvement and soft tissue swelling in 10 cases and abscess in 5 cases. CONCLUSION: We concluded that CT was useful in the differentiation between infectious sacroiliitis and ankylosing spondylitis.
Abscess ; Follow-Up Studies ; HLA-B27 Antigen ; Humans ; Ilium ; Retrospective Studies ; Sacroiliitis* ; Sclerosis ; Spondylitis, Ankylosing* ; Tomography, X-Ray Computed

No abstract available.
Skin Neoplasms* ; Skin*

We evaluated the distribution of normal conjuctival flora and the change of antibiotic sensitivity of cultured bacteria. Specimens were obtained from inferior conjunctiva cul de sac with sterile cotton-tipped applicator from healthy 216 human beings. Antibiotic sensitivity test was done by disk diffusion method. The results indicated that overall positive culture rate was 47.7% and major organisms were Coagulase-negative Staphylococcus(55.7%), Staphylococcus aureus(16%), Gram negative bacteria(7.5%), Streptococcus(4.7%). Antibiotic sensitivity test of cultured Gram positive bacteria demonstrated less than 60% rate of susceptability in gentamicin, tetracyclin, erythromycin and 80.5% rate of susceptability in ciprofloxacin. Gram negative bacteria demonstrated less than 60% rate of susceptability in cephalothin, ampicillin. From the above results, we concluded that antibiotic resistance of normal conjunctival flora was increased from the past and the principle of antiviotic eye drop use should be emphasized.
Ampicillin ; Bacteria ; Cephalothin ; Ciprofloxacin ; Conjunctiva ; Diffusion ; Drug Resistance, Microbial ; Erythromycin ; Gentamicins ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Staphylococcus

No abstract available.
Folliculitis ; Herpes Zoster ; Herpesvirus 3, Human

BACKGROUND: The red cell distribution width(RDW) has been reported to be of value in discriminating iron deficiency anemia(IDA) from the anemia of the other causes(non-IDA). The combination of a low MCV and a high RDW may indicate iron deficiency anemia. The purpose of this study was to discriminate IDA from anemia, using automated blood cell count alone. METHODS: We collected 139 cases of anemia in outpatients, with 80 cases of IDA and 59 cases of anemia due to other causes, from July 1995 to September 1996 in department of family medicine, Pusan Paik hospital. RESULTS: The sex distribution was 39(28.1%) in male, 100(71.9%) in female. The age distribution was 15 to 79 year. The hemoglobin level and MCV in IDA(9.5+/-1.6g/dl, 77.5+/-8.9fl) was significantly lower than those in non-IDA(10.1+/-1.5g/dl, 87.6+/-10.5fl)(P=0.042, P<0.001, respectively). And mean RDW in IDA(16.9+/-3.3%) was significantly higher than that in non-IDA(15.1+/-3.2%)(P<0.001). In discriminating IDA from anemia, we drew receiver operating characteristic curves (ROC curves) with each value of MCV and RDW. The cut-off value of MCV was 83fl, and in that value, the sensitivity and specificity were 75.9% and 72.9%, respectively. The cut-off value of RDW was 14.3%, and the sensitivity and specificity were 78.2% and 57.6 %, respectively. We combined each value of MCV with RDW, the cut off value were 83fl of MCV and 14.3% of RDW, and the sensitivity and specificity were 76.3% and 71.3%, respectively. CONCLUSIONS: The sensitivity and specificity of MCV, RDW and combination of MCV and RDW were not so high in discriminating IDA from the anemia of the other causes in ambulatory patients.
Age Distribution ; Anemia* ; Anemia, Iron-Deficiency ; Blood Cell Count ; Busan ; Female ; Humans ; Iron ; Male ; Outpatients ; ROC Curve ; Sensitivity and Specificity ; Sex Distribution

BACKGROUND: Non ulcer dyspepsia(NUD) is a commonly encountered disease at the primary practice. The relations of functional gastrointestinal disorder and Irritable bowel syndrome with depression or stress were suggested by previous studies. But the contributions of the anxiety, depression and stress as a whole to the NUD were not assessed. In this study, we wanted to show the associations of the anxiety, depression and stress levels with NUD. METHODS: This study was performed by case and control method from Aug. 1 to Sep. 7 at the outpatient department of Family Medicine and at the Health Management and Service department in Pusan Paik Hospital. The both groups were matched by sex and age. The case was defined who has three or more symptoms among nine upper gastrointestinal symtoms like dyspepsia, epigastric pain and anorexia etc. frequently or alwalys and who has no ulcer at the gastrofibroscope. The anxiety, depression, stress levels were measured by questionnaire which was validated by previous studies. The questionnaire was composed of Trait-STAI, Jung's Self Depression Scale(SDS), Modified BEPSI, and Grobal Assessment of Recent Stress(GARS) Scale. RESULTS: The total subjects were 136 persons(NUD group : 86 persons/control group : 86 persons). There were. significant differances in regularity of diet(P<0.001), levels of education(P=0.009), and history of medications(P<0.001) between two groups. The two group had higher scores than the control group in the depression score, anxiety score and modified BEPSI score(P<0.001). All items in GARS showed higher scores in NUD group than in control group(P<0.001). CONCLUSIONS: NUD group had higher degree of anxiety and depression than the control group. It seems that the NUD may have streeful status. When we encounter the NUD in outpatiet department, we had better consider the underlying psychogenic or stressful conditions.
Anorexia ; Anxiety* ; Busan ; Depression* ; Dyspepsia* ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Ulcer* ; Surveys and Questionnaires

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis